Waraich Paul, Goldner Elliot M, Somers Julian M, Hsu Lorena
Mental Health Evaluation and Community Consultation Unit, University of British Columbia, Vancouver.
Can J Psychiatry. 2004 Feb;49(2):124-38. doi: 10.1177/070674370404900208.
To present the results of a systematic review of literature published between January 1, 1980, and December 31, 2000, that reports findings on the prevalence and incidence of mood disorders in both general population and primary care settings.
We conducted a literature search of epidemiologic studies of mood disorders, using Medline and HealthSTAR databases and canvassing English-language publications. Eligible publications were restricted to studies that examined subjects aged at least 15 years and over. We used a set of predetermined inclusion and exclusion criteria to identify relevant studies. We extracted and analyzed prevalence and incidence data for heterogeneity.
Of general population studies, a total of 18 prevalence and 5 incidence studies met eligibility criteria. We found heterogeneity across 1-year and lifetime prevalence of major depressive disorder (MDD), dysthymic disorder and bipolar I disorder. The corresponding pooled rates for 1-year prevalence were 4.1 per 100, 2.0 per 100, and 0.72 per 100, respectively. For lifetime prevalence, the corresponding pooled rates were 6.7 per 100, 3.6 per 100, and 0. per 100, respectively. Significant variation was observed among 1-year incidence rates of MDD, with a correspond ing pooled rate of 2.9 per 100.
The prevalence of mood disorders reported in high-quality studies is generally lower than rates commonly reported in the general psychiatric literature. When controlled for common methodological confounds, variation in prevalence rates persists across studies and deserves continued study. Methodological variation among studies that have examined the prevalence of depression in primary health care services is so large that comparative analyses cannot be achieved.
呈现对1980年1月1日至2000年12月31日期间发表的文献进行系统综述的结果，这些文献报告了普通人群和初级保健机构中情绪障碍的患病率和发病率。
我们使用Medline和HealthSTAR数据库对情绪障碍的流行病学研究进行文献检索，并查阅英文出版物。符合条件的出版物仅限于研究年龄至少为15岁及以上受试者的研究。我们使用一组预先确定的纳入和排除标准来识别相关研究。我们提取并分析患病率和发病率数据以评估异质性。
在普通人群研究中，共有18项患病率研究和5项发病率研究符合资格标准。我们发现重度抑郁症（MDD）、心境恶劣障碍和双相I型障碍的1年患病率和终生患病率存在异质性。1年患病率的相应合并率分别为每100人中有4.1例、2.0例和0.72例。对于终生患病率，相应的合并率分别为每100人中有6.7例、3.6例和0例。观察到MDD的1年发病率存在显著差异，相应的合并率为每100人中有2.9例。
高质量研究报告的情绪障碍患病率通常低于普通精神病学文献中通常报告的患病率。在控制常见的方法学混杂因素后，研究之间患病率的差异仍然存在，值得继续研究。在初级卫生保健服务中检查抑郁症患病率的研究之间的方法学差异如此之大，以至于无法进行比较分析。
